CMS Price Transparency Data

Blood test, liver function panel

Facility: Franklin General Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $82
Cash Discount Price: $176
vs. Medicare Baseline: 10.04x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Franklin General Hospital is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 10.04x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$176

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)

Cash / Self-Pay: $176 (2154%)

Insurance Median: $82 (1004%)

Cash: $176 (2154% of Medicare)

Ins. Median: $82 (1004% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1004% of the Medicare baseline (a markup of 904%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$16 - $162	196%
Wellmark Hmo	$52	636%
Wellmark Ppo - All Other Plans	$57	698%
Medical Associates Mcare	$78	955%
Mount Carmel Hp-All Plans	$78	955%
Tricare	$78	955%
Amerigroup Mcare	$79	967%
Wellmark Mcr Adv	$79	967%
Molina Mcare	$81	991%
Ambetter / Centene	$82 - $125	1004%
American Hp Iowa - All Plans	$82	1004%
Amerigroup Mcaid - All Other Plans	$82	1004%
Molina Mcaid - All Other Plans	$83	1016%
Centivo - All Plans	$117	1432%
Medical Ass Hosp Employer Group	$117	1432%
Oscar - All Plans	$117	1432%
Midlands Choice-All Plans	$136	1665%
Medical Associates Hp-All Other Plans	$166	2032%
Preferred Health Choices-All Plans	$166	2032%
Splashlight Llc-All Plans	$166	2032%
Aetna	$181 - $185	2215%
Multiplan-All Plans	$185	2264%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $176.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80076.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Franklin General Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80076.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.